Exploration of multimodal alternative access for individuals with severe motor impairments: Proof of concept.

Many individuals with complex communication needs and severe motor impairments are unable to control technologies through conventional means and require alternative access techniques to achieve accurate and efficient access. With current alternative access techniques, individuals with severe motor impairments are limited in that they can only use one access technique at a time. The purpose of this project was to test proof of concept of a new multimodal access technique which integrated eye gaze and single switch scanning selection techniques. The aims were to investigate the learning patterns of two adults with severe cerebral palsy when first introduced to the multimodal access technique and then to compare the accuracy and efficiency of multimodal to single-modality access when selecting targets on an AAC visual scene display. The participants learned to use the multimodal access technique; they demonstrated improvements in their accuracy of selection across sessions and attained at least 80% accuracy within 3-15 training sessions. Both participants achieved similar accuracy with multimodal access compared to single-modality, but took longer to select targets with multimodal access compared to single-modality. The potential utility of multimodal access is explored as well as important avenues for future research.

The Effects of an Online Training on Preservice Speech-Language Pathologists' Use of Family-Centered Skills.

Purpose Despite the recognition that family-centered services are best practice in augmentative and alternative communication services, many speech-language pathologists (SLPs) are lacking in their acquisition and implementation of family-centered skills. The purpose of this study was to evaluate the effects of online instruction in a family-centered, relational skills strategy on preservice SLPs use of family-centered skills. Method A switching replications design was used to evaluate the effects of an online training on the use of family-centered behaviors by 15 preservice SLPs who were randomly assigned to two groups. The online training taught the students a four-step relational skills strategy (summarized by the acronym LAFF): (a) Listen, empathize, and communicate respect; (b) Ask questions; (c) Focus on the issues; and (d) Find a first step. Participants were videotaped during interactions with simulated parents before and after the training. Results After an average of 61 min of instruction via the online module, all of the preservice SLPs significantly improved their demonstration of relational skills. Additionally, one parent of a child who used augmentative and alternative communication viewed the video recordings and chose 14 of the 15 postinstruction role plays as more family-centered. Conclusion The findings from this study provide support for the use of an online environment to teach preservice SLPs family-centered relational skills. In order to prepare future SLPs and ensure the delivery of family-centered services, future research is necessary, including investigations to determine whether other family-centered skills can be effectively taught through an online environment. Supplemental Material https://doi.org/10.23641/asha.12462344.

Video Visual Scene Displays with Dynamic Text: Effect on Single-Word Reading by an Adolescent with Cerebral Palsy.

PURPOSE: The purpose of this study was to investigate the effect of the Transition to Literacy (T2L) feature within video visual scene displays (VSDs) on the single-word reading of academic vocabulary concepts (i.e., weather concepts) by a pre-literate adolescent with cerebral palsy and minimal speech. METHOD: A single-subject, multiple probe, across word sets design was used to evaluate the effects of the intervention. The intervention used an AAC app programmed with video VSDs embedded with hotspots with the T2L feature to teach the adolescent 12 academic vocabulary words. RESULTS: The adolescent acquired all target words successfully with only minimal exposure to the written words through the app and was able to generalize her learning to two novel tasks. Using Tau-U to evaluate the size of the observed effects, there were very large effects across all word sets. CONCLUSION: The findings from this study demonstrate the effectiveness of the T2L feature to improve single-word reading in pre-literate individuals with minimal speech. The use of video VSDs and T2L technology together may offer professionals a unique way to complement current AAC devices and literacy instruction for adolescents with minimal speech who are pre-literate.

Digital Books with Dynamic Text and Speech Output: Effects on Sight Word Reading for Preschoolers with Autism Spectrum Disorder.

Despite the importance of literacy in today's educational curriculum, learning to read is a challenge for many children with autism spectrum disorder (ASD). One of the foundational skills of early literacy learning is the ability to recognize sight words. This study used a single-subject, multiple-probe, across-participants design, to investigate the effects of a new software feature, dynamic text and speech output, on the acquisition of sight words by three pre-literate preschoolers with ASD during shared digital book reading experiences. All participants demonstrated successful acquisition of the target sight words with minimal exposure to the words. Limitations and future research directions are discussed, including the importance of investigating how the new software feature can be integrated into a more comprehensive literacy curriculum.

The effects of literacy interventions on single-word reading for individuals who use aided AAC: a systematic review.

The purpose of this systematic review was to investigate the effects of instruction on single-word reading of individuals who use aided augmentative and alternative communication (AAC). A systematic search identified nine single-case experimental design studies that involved 24 individuals who used aided AAC. Overall, the evidence indicated that instruction had positive effects on reading at the single-word level for individuals across ages and diagnostic categories (i.e., autism spectrum disorder (ASD), cerebral palsy (CP), Down syndrome, and intellectual disability). The studies revealed that these effects were consistent across a range of participant, intervention, and outcome measure characteristics. Phonological approaches, sight-word approaches, and a combination of these two approaches yielded very large effects. Despite the large effects, the findings must be viewed with caution due to limitations in the number of studies and participants and limitations in the reporting of detailed participant and intervention characteristics across the studies. In order to determine which interventions are most effective for which individuals, future research directions are discussed, including the need for greater specificity in describing participant and intervention characteristics, investigations into how to best measure intervention outcomes without requiring spoken responses, and investigations into longer-term interventions targeting a wider range of reading skills.

Family-centered services for children with complex communication needs: the practices and beliefs of school-based speech-language pathologists.

This study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists (SLPs) who served children with complex communication needs regarding their provision of family-centered services. Participants revealed that despite their desire for family involvement and reported beliefs in the importance of family-centered services, there were barriers in place that often limited family-centered service provision. Across the SLPs, many were dissatisfied with their current provision of family-centered services. The SLPs varied in their reported practices, with some reporting family-centered services and others, professional-centered services. Future research is recommended in order to investigate which factors contribute to the variation among SLPs and how the variation impacts children who require augmentative and alternative communication (AAC) and their families. Potential clinical implications for in-service and pre-service SLPs are discussed to improve future family-centered AAC services.

Family-centered Services for Children with ASD and Limited Speech: The Experiences of Parents and Speech-language Pathologists.

Although family-centered services have long been discussed as essential in providing successful services to families of children with autism spectrum disorder (ASD), ideal implementation is often lacking. This study aimed to increase understanding of how families with children with ASD and limited speech receive services from speech-language pathologists (SLPs). 99 parents of children with ASD and limited speech and 211 SLPs who served children with ASD and limited speech completed questionnaires measuring their experiences with the provision of family-centered services. Findings revealed that parents and SLPs differed in their views on the degree to which family-centered services were being implemented. Clinical implications and future research directions are discussed in order to promote continued growth in the acquisition of family-centered skills.

Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.